The Hyper-specialization of Medicine

My most recent article, by the same title, light-heartedly approaches a topic that can be very frustrating for patients seeking answers in our current hyper-specialized health delivery system.  Patients seek care from primary care physicians/providers (family practitioners, internist, pediatricians, nurse practitioners, physician assistants, and others) for complex issues, but rather than finding answers, they sometimes only receive 15 minutes of the physician’s attention before being referred to a specialist.  After a long wait to see the specialist and a few visits, they may be told that nothing wrong was found and sent back to the primary physician without an answer or told they need another specialist referral.  The list of physician consults may extend over months.

What is the root cause of this dilemma?  Our system is designed for pressing the primary physicians into shorter and shorter appointment slots.  Administrative costs drive the physician to shorten their visits more so more patients can be seen in a day.  Direct Primary Care is one solution for this dilemma.  By contracting directly with patients for care payment, physicians can have more time (45 to 60 minutes in some cases) to spend with complex patients, often decreasing the need for costly referrals.  Patients can receive ongoing care from someone they know and trust, being referred not because their primary doesn’t have the time, but only for when a consult is appropriate.

Sanctuary Medical Care and Consulting offers this old-fashioned care as do other direct pay practices.  I would love to hear your thoughts on my article and this commentary.   Also, stay tuned for my short sequel to the saga of the drunken elephant.  I couldn’t resist poking fun at my own specialty, Internal Medicine/Pediatrics in the next article.

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